constipation-diarrhea.ppt reporting.nursing

Reporting PPT

1. CONSTIPATION
and
DIARRHEA
Presented by:
Arellano, Jashley
Villota, Ralph Terence

2. Topic
Topic 1: CONSTIPATION
Topic 2: DIARRHEA

3. CONSTIPATION
A fewer than 3 bowel movements weekly or bowel
movements that are hard, dry, small, or difficult to pass.
It is a symptoms and not a disease.
Also a result o dietary habits.

4. Primary constipation
Normal transit constipation
Slow transit constipation
Outlet constipation
Secondary constipation
that occurs as a result of an underlying health issue or
a side effect of medication use
Classification

5. PATHOPHYSIOLOGY

6. Laboratory & Diagnostic findings
take patients history
Physical examination, Stool testing for occult blood.
These test are used to determine whether this symptoms result from spasm or narrowing of
bowel.
Defecography.
provides information on anatomic and functional changes of the anorectum. The diagnostic
exam may expose poor activation of levator muscles, delayed retention of contrast material, or
inability to remove the barium in clients with dyssynergic defecation (incoordination of pelvic
floor muscle)
MRI (Magnetic resonance imaging)
This technique facilitates analysis of anorectal angle, the opening of the anal canal, pelvic
floor descent during defecation, and functioning of the puborectal muscle.
Clear visibility of the rectal wall can reveal intussusceptions and rectoceles. Visibility of
structures surrounding the rectoanal can uncover enteroceles.

7. take patients history
Laboratory & Diagnostic findings

8. take patients history
HEMORRHOIDS
Dilated portions of anal veins.
Develops as a result of perineal vascular congestion
caused by straining.
Anal fissures may result from the passage of hard stool
through the anus, testing the lining of the anal canal.
FECAL IMPACTION
Occurs when an accumulated mass of dry feces cannot
expelled.
Complications

9. Medical mangement
This includes education, exercise, bowel habit training,
increased fibre & fluids intake.
Patient can be educated to sit on the toilet with legs
supported and utilize the Gastrocolic reflex.
Routine exercises to strengthen abdominal muscles is
encouraged.
Biofeedback is a technique that can help patient learn to
relax the sphincter mechanism to expel stool.
laxatives use is necessary as prescribed: fibre Laxatives,
saline and osmotic agents.

10. Nursing
Management
Nurse must elicits information about the onset and duration
of constipation, current and past elimination patterns.
Obtain health history of the patient. past medical history,
surgical history, and current medication and if the use of
laxative. Perform abdominal assessment.Check the presence
of emotional distress.Observe stool characteristics.
ASSESSMENT
Nursing Diagnosis
Constipation related to
decreased dietary intake

11. Nursing
Management
Advised patients to take the recommended dose of dietary
fiber of at least 20 to 30 g daily. Encourage intake of prune
juice.
Avoid caffeine and alcohol.
Advise the patient to do physical activities.
Assist the patient in doing physical activity and exercise.
Advise taking probiotics if indicated.
Educate about biofeedback therapy for constipation.
INTERVENTION

12. EVALUATION
Restoring and monitoring a regular pattern
of bowel movement.
Ensuring adequate intake of fluids and
high-fiber foods.
Learning methods to avoid constipation
Relieved anxiety about bowel elimination
patterns, and avoiding complications.

13. Diarrhea is an increased frequency of bowel movements with altered
consistency that is called increased liquidity of stool.
It can be associated with urgency, perianal discomfort, incontinence,
nausea, or a combination of these factors.
Any condition that causes increased intestinal secretions, decreased
mucosal absorption, or altered motility can produce diarrhea.
DIARRHEA

14. Acute diarrhea is self-limiting, lasting 1
or 2 days
Persistent diarrhea typically lasts
between 2 and 4 weeks
Chronic diarrhea persists for more
than 4 weeks and may return spo-
radically.
Acute and persistent diarrheas are frequently caused by
viral infections like norovirus
Some drugs can cause acute or persistent diarrhea,
including some antibiotics like erythromycin and
magnesium-containing antacids like magnesium
hydroxide.
Chronic diarrhea may be caused by adverse effects of
chemotherapy, antiarrhythmic agents, antihypertensive
agents,
metabolic and endocrine disorders
mal-absorptive disorders
anal sphincter defect,
Zollinger-Ellison syndrome,
acquired immune deficiency syndrome (AIDS),
parasitic or Clostridium difficile infections.
DIARRHEA
can be classified as:
Acute, Persistent, and
Chronic.

15. PATHOPHYSIOLOGY
Acute and persistent diarrheas are classified as either nonin-
flammatory (large-volume) or inflammatory (small-volume).
Enteric pathogens that are noninvasive (staphylococcus aureus,
Giardia) do not cause inflammation but secrete toxins that disrupt
colonic fluid transport.
Other pathogens that invade the intestinal mucosa and cause
inflammatory changes typically result in smaller volumes of stool
that is bloody (dysentery). Organisms implicated may include
Shigella, Salmonella, and Yersinia species

16. PATHOPHYSIOLOGY
OSMOTIC
INFCTIOUS
EXUDATIVE
OSMOTIC PRESSURE OF
UNABSORBED PARTICLES
DIARRHEA
SECRETORY
MAL- ABSORPTIVE
INCREASE IN
INTESTINAL CONTENTS
INHIBITING EFFECTIVE
ABSORPTION
INVADING THE
INTESTINAL MUCOSA
CHANGE IN MUCOSAL
INTEGRITY

17. Clinical
Manifestation
Abdominal cramps, distention, borborygmus (a rumbling noise caused by the
movement of gas through the intestines)
Anorexia, and thirst.
Painful spasmodic contractions of the anus and tenesmus
Other symptoms depend on the cause and severity of the diarrhea but are
related to dehydration and to fluid and electrolyte imbalances.

18. Complications
The most common complication of diarrhea is dehydration.
Dehydration with electrolyte loss especially loss of potassium may cause
cardiac arrhythmias.
Loss of bicarbonate with diarrhea can also lead to metabolic acidosis.
Chronic diarrhea can also result in skin care issues related to irritant
dermatitis

19. Diagnostic tests may be performed:
complete blood cell count (CBC)
serum chemistries
urinalysis
routine stool examination
stool examinations for infectious or parasitic organisms, bacterial toxins,
blood, fat, electrolytes, and white blood cells.
Endoscopy or barium enema may assist in identifying the cause.
LABORATORY & DIAGNOSTIC PROCEDURES

20. LABORATORY & DIAGNOSTIC PROCEDURES

21. MEDICAL MANAGEMENT
Infection control measures that restrict the transmission of
infectious organisms (e.g., Clostridioides difficile-associated
diarrhea)
medications are antibiotics, anti-inflammatory agents and
antidiarrheal agents (e.g., loperamide, diphenoxylate with
atropine).

22. Nursing Mangement
Nursing Assessment
1. General Health Status:
Vital signs: Temperature, pulse, blood pressure, respiratory rate, and oxygen saturation
Overall appearance: Skin turgor, mucous membranes, and conjunctiva
2. Gastrointestinal System:
Abdominal pain or tenderness
Bowel habits: Frequency, consistency, and volume of stools
Presence of blood or mucus in stool
Rectal examination: presence of hemorrhoids, rectal pressure, or masses
3. Fluid and Electrolyte Status:
Fluid intake and output: Amount of fluids consumed and amount of urine produced
Electrolyte levels: Serum sodium, potassium, chloride, and bicarbonate levels
Signs of dehydration: Dry mucous membranes, decreased urine output, decreased blood
pressure, and increased pulse rate

23. Nursing Mangement

4. Nutritional Status:
Dietary history: Recent food intake and dietary changes
Nutritional deficiencies: Malnutrition, vitamin deficiencies (e.g., vitamin B12), or mineral
deficiencies (e.g., iron)
5. Psychosocial Status:
Emotional state: Anxiety, stress, or depression related to illness
Coping mechanisms: Patient's ability to manage symptoms and adapt to changes in their
condition
6. Environmental Factors:
Hygiene practices: Handwashing habits, disposal of feces, and use of gloves when handling
contaminated objects
Living conditions: Presence of contaminated water sources, poor sanitation, or
overcrowding

24. Nursing Mangement
Nursing Diagnosis:
- Alteration in bowel function characterized by an increase in frequency, looseness, and
fluidity of stool
- Risk for Fluid Volume Deficit related to diarrhea and vomiting
- Alteration in the balance of electrolytes (sodium, potassium, chloride, and bicarbonate) in
the body
- Loss of skin integrity due to dehydration and diarrhea
- Deficient Knowledge related to lack of understanding of proper hygiene practices
Planning/Outcome:
-Patient will experience a decrease in frequency and severity of diarrhea
- Patient's fluid and electrolyte status will be restored to normal
- Patient will demonstrate knowledge of proper hygiene practices and disease transmission
prevention

25. NURSING
INTERVENTION
1. Fluid Replacement: Administer oral rehydration solution (ORS) as prescribed,
and monitor urine output and electrolyte levels.
- Fluid replacement helps to restore lost fluids and electrolytes, reducing the risk of
dehydration.
2. Anti-diarrheal Medication: Administer anti-diarrheal medication as prescribed to help
slow bowel movements.
- Anti-diarrheal medication helps to slow bowel movements, reducing the frequency
and severity of diarrhea.
3. Bland Diet: Provide a bland diet that is easy to digest, such as bananas, rice,
applesauce, and toast (BRAT diet).
- A bland diet helps to reduce symptoms of diarrhea and prevent further irritation of
the digestive tract.

26. NURSING
INTERVENTION

4. Hygiene Education:Educate patient on proper hygiene practices, including
handwashing, proper disposal of feces, and use of gloves when handling
contaminated objects.
- Hygiene education helps to prevent the spread of infection and reduce the
risk of re-infection.
5. Monitoring: Monitor patient's vital signs, including temperature, pulse, and
blood pressure; assess for signs of dehydration.
- to assess furthermore

27. Patient's frequency and severity of diarrhea
decrease
Patient's fluid and electrolyte status returns to
normal
Patient demonstrates knowledge of proper
hygiene practices and disease transmission
prevention
Evaluation: